What’s the news: The AMA urges governors to immediately adopt new U.S. Drug Enforcement Administration (DEA) guidance allowing physicians and other authorized practitioners prescribe buprenorphine to new and existing patients with opioid-use disorder (OUD) via telephone during the COVID-19 public health emergency.

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The guidance allows for buprenorphine to be prescribed to new patients with OUD following an evaluation via a telephone call and without first performing an in-person or video telemedicine evaluation.

The new policy went in effect March 31 and will be in place for the duration of the COVID-19 emergency. It is designed to provide flexibility in the prescribing and dispensing of controlled substances to ensure necessary patient therapies remain accessible, according to the DEA.

Why it’s important: “This guidance removes a considerable barrier for many patients during this national emergency and, importantly, allows them to stay at home,” said AMA President Patrice A. Harris, MD, MA. “The AMA commends the DEA for its new policy and urges all states to take this action to support greater access to treatment for patients with OUD.”

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The AMA also released policy recommendations to help patients with OUD and pain as well as how states can provide support harm-reduction efforts. Recommendations include:

  • Remove restrictions on Medicaid preferred drug lists to help avoid medication shortages. This includes ensuring coverage for methadone for patients receiving care in an opioid treatment program.
  • Waive testing requirements and in-person counseling requirements for refills for patients with chronic pain and allow for telephonic counseling to fulfill state prescribing and treatment requirements.
  • Assist harm-reduction organizations to help ensure adequate supplies of naloxone to continue community-based naloxone distribution efforts.
  • Ensure continuity of syringe services programs, including provision of personal protection equipment (PPE).
  • Expand PPE priority to include harm-reduction organizations and other community-based organizations that provide services to people who inject drugs to help protect against the spread of infectious disease.

The AMA also is urging states to adopt policies such as those included in a new Minnesota law to help patients maintain access to medication. The law, enacted in response to the COVID-19 global pandemic, allows Schedule II-V controlled substances to be dispensed for more than 30 days and removes existing refill limitations. These new policies, part of the American Medical Association's top policy recommendations for states, will allow patients with chronic diseases to stay home during shelter-in-place and other physical-distancing efforts aimed at limiting the spread of COVID-19.

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To learn more: The AMA has been listening to physicians to identify changes in federal policy that are needed due to COVID-19 and advocating for the administration to take a number of specific actions to improve access to services and to reduce regulatory burdens on physicians during the public health emergency. This includes widening access to and coverage of telehealth services. An AMA Fact Sheet identifies areas where its recommended actions have been carried out.

To assist those who care for patients with a substance-use disorder, mental illness or chronic pain during the COVID-19 pandemic, the AMA has created a resource webpage for physicians.

The AMA has also released the “National Roadmap on State-Level Efforts to End the Opioid Epidemic; Leading-edge Practices and Next Steps,” which analyzes successful statewide strategies to guide policymakers in other states.

Physicians can stay up to date on the AMA’s COVID-19 advocacy efforts and track the fast-moving pandemic with the AMA's COVID-19 resource center, which offers a library of the most current resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization. 

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